The results from our SB1518 study are in good agreement with the notion that allergy/atopy is extremely commonly found. On the other hand, the fact that 30% of the atopic children did not have a family history of allergy agrees with investigators claiming that a great portion of newly diagnosed allergics/atopics do not have a family history of allergy/atopy [4]. Thus it could be stated that family history is no longer practical in predicting allergic disease. This study population represents a selected cohort as Voksentoppen is a hospital having referred patients with allergy-like symptoms and allergic diseases from general paediatricians in the whole country, often of a more severe character. This explains the unusual high prevalence of atopy, 70%, in this population.

However, other studies have shown that Phadiatop Infant could be applied in populations with a lower prevalence of atopy, still demonstrating good performance characteristics [17, 18, 21]. The clinical appearance of allergy in our study is in agreement with the concept of the allergy march and supports what has been reported earlier from other studies [7, 8]. Eczema was the predominating symptom among the atopic children below 2 years. Thus, eczema was not common in the nonatopic group of children and only one of the 31 children with eczema was classified as nonatopic. The progression from eczema to other allergic problems was also demonstrated in this study. Eighty-six percent of the children with eczema and wheezing in combination with other symptoms were found in the older age group and as many as 82% were classified as atopic.

The majority of children, all ages, presenting with wheezing were nonatopic (73%). Many infants and children who wheeze have transient conditions associated with diminished airway function and do not have an increased risk of asthma later in life. However, children with persistent wheezing, starting during the first years of life, and with an atopic heredity, should be considered being at risk for asthma later during childhood [11, 22, 23]. Therefore, an early diagnosis of IgE sensitisation may be important for the choice of treatment to wheezing toddlers. Children with allergic symptoms usually present at a general paediatrician who needs to discriminate which patients have to be sent to an allergist for further evaluation.

Possible diagnostics interventions to avoid unnecessary referrals are discussed in a recently published paper. Rule-out tests with a high discriminating potential are suggested to have a gateway function to fulfil this differentiation and an important role to prevent the march of allergic Cilengitide children from the first to secondary level of care [24]. The present study shows that Phadiatop Infant has a diagnostic performance with a high sensitivity and specificity.